Robotic Gallbladder Surgery

For Anthony Tirado, recovery from the gallbladder surgery he recently underwent at Beth Israel Deaconess Medical Center was very quick. "I feel great," he said. "I had no trouble at all after surgery."

Tirado, 39, whose surgeon was Benjamin Schneider, MD, underwent the first single-incision robotic gallbladder surgery in Boston. For the one million people who need gallbladder surgery each year, this single-incision surgery is great news.

Dr. Schneider told Mr. Tirado that the only way to eliminate his severe gallbladder troubles was surgery. He suggested a newer approach called a single-site robotic cholecystectomy (gallbladder removal), which is performed through a single small incision using the hospital's state-of-the-art robotic technology.

Traditional open gallbladder removal involves a six-inch incision under the right rib. Today, about 90 percent of gallbladder removals are done minimally invasively (laparoscopically), in which the surgeon makes three to four small (one to two-inch) incisions. Through these, scopes and other surgical tools can be inserted to view and remove the organ.

With this new single-site surgery, only one incision, or "port," is made at the navel (belly button) through which all instruments are inserted. For Tirado, the scar is almost impossible to see.

The state-of-the-art robotic surgical platform translates the surgeon's hand movements into smaller, precise maneuvers of instruments within the patient's body. Throughout the entire procedure, the surgeon sits at a console next to the patient and is in complete control of the robotic system.

Dr. Schneider says there are many advantages to this robot-assisted method. "There is minimal scarring, of course, and minimal pain and very low blood loss," he says. "The hospital stay is short as well, and the patient is back on his feet soon after surgery."

Dr. Schneider also believes that the robotic method offers surgeons better control and greater access compared to manual laparoscopic procedures.

Standard laparoscopic surgery instruments are rigid, "like chopsticks," whereas the instruments used in the robotic approach are flexible, explains Dr. Schneider. In addition, the robotic system allows the surgeon to see in three dimensions and high definition, which aids in doing the operation safely. "It's a big advancement," says Dr. Schneider.

The single-site gallbladder surgery is the latest procedure to be added to the Department of Surgery's growing roster of robotic procedures for patients with conditions affecting the pancreas, colon, prostate, bladder, kidneys, and lungs.

It is anticipated that other operations, such as procedures for reflux, achalasia (an esophageal disorder), weight loss, and many other conditions will be possible in the not-too-distant future using the robotic approach at experienced robotic centers such as BIDMC, says Dr. Schneider.